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The use of type brain natriuretic peptide in a cardiac surgery postoperative context

Background

Several scientific publications have shown the importance of the brain natriuretic peptide (BNP).

Objective

To evaluate the BNP kinetics and its correlation with oxyhemodynamic variables at the postoperative (PO) stage of cardiac surgery (CS).

Methods

A classical cohort was carried out with 22 patients undergoing CS, who were consecutively selected from August 2003 to January 2004. The mean age of the patients was 65.7 ± 8.18 years, and three were females (13.6%). The type B BNP was dosed before (Pre-BP), at the first hour (BNP 1) and the sixth hour (BNP 6) PO. The laboratory and hemodynamic data were also registered. The quantitative dosage of BNP was done by the immunofluorescence method (Biosite Triage BNP test). The results underwent statistical analysis with the following tests: chi-square, Student t, Mann–Whitney, and Pearson, followed by logistic regression and stepwise (likelihood ratio).

Results

No significant difference among Pre-BNP and BNP 1 was found (P = 0.84), but the opposite occurred when comparing pre-BNP and BNP6 (P = 0.0004). BNP 1 was significantly related to the first hour PAM (PAM 1), P = 0.023; with the (DELTAPP), P = 0.292; Spearman rho = 0.475913, which produced the possible correlation equations: PAM 1 hour = (89.8432 + 0.0356) × BNP and DELTAPP = (12.7283 - 0.0087) × BNP. There was no correlation between the use of VA (dobutamine or noradrenaline) and the BNP 1 and BNP 6. The MODS was correlated to BNP 6 (P = 0.01 and rho = 0.524) but no significant correlation between the BNP 1 and the PO evaluated variables was found. The BNP 1, BNP 6 and the BNP were not able to predict a longer length of stay in the surgical ICU or greater MODS at the third day.

Conclusion

Preliminary data show a BNP kintetics curve at PO CS, as well as a linear correlation among BNP 1 and PAM 1 hour and DELTAPP and BNP 6. The MODS score was correlated to BNP 6. The noncorrelation with the outcome variables may be related to the sample size.

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Rouge, A., Gomes, R., Nogueira, P. et al. The use of type brain natriuretic peptide in a cardiac surgery postoperative context. Crit Care 9, P328 (2005). https://doi.org/10.1186/cc3391

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Keywords

  • Noradrenaline
  • Likelihood Ratio
  • Dobutamine
  • Brain Natriuretic Peptide
  • Longe Length